NPI | 1437437449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IA 08848) |
Additional Taxonomies | 122300000X Dentist (Licence: IA 08848) |
Enumeration Date | 2011-07-25 |
Last Update Date | 2023-11-15 |